Gainesville doctor charged for fraud over genetic testing

Monday

Editor's note: The headline in the online version of this story has been changed to note that the scheme involved Medicare.

Federal investigators say a Gainesville doctor with ties to North Florida Regional Medical Center and the University of Florida authorized genetic testing for patients he never met, in a state where he is not licensed to practice, so that he could profit from millions of dollars worth of false Medicare claims.

Dr. Matthew Stewart Ellis, 53, is being charged in the United States District Court of New Jersey with conspiracy to commit health care fraud, following an investigation by the U.S. Department of Justice, U.S. Department of Health and Human Services Office of the Inspector General, and the Federal Bureau of Investigation.

Thirty-five defendants in five federal districts are facing charges for their alleged participation in one of the largest health care fraud schemes ever charged. The defendants associated with telemedicine companies and cancer genetic testing laboratories fraudulently charged Medicare more than $2.1 billion for tests patients did not ask for or need, according to an Department of Justice news release.

Ellis' lead attorney, Rocco Cipparone Jr., said the case is still early in its proceedings, but that his client "steadfastly maintains his innocence."

Ellis operates an independent wound therapy practice that is affiliated with North Florida Regional Medical Center, but is not employed by the hospital. The allegations do not appear related to his work at the Gainesville hospital.

The District Court of New Jersey said in a news release Thursday that Ark Laboratory Network LLC and Privy Health Inc. partnered to illegally acquire DNA samples and Medicare information from hundreds of patients nationwide.

Ellis served as Privy Medical’s director, according to an indictment filed by the District Court of New Jersey.

The indictment laid out a list of detailed allegations that follow. Between July 2018 and January 2019, Ellis received about $5,000 a month for his role as Privy’s director. During this period, Ellis falsely reported himself as patients’ ordering physician so he could order genetic testing for them. He received a portion of the money Medicare paid to clinical laboratories for the tests.

In 2018 alone, Medicare paid clinical laboratories at least $4.6 million for genetic tests that Ellis ordered in this manner. Ellis allegedly authorized his signature on patient documents to order tests for patients he had never met, treated or evaluated.

In certain cases, some labs told patients they had a personal or family history of cancer, when, in fact, the patient had no cancer history whatsoever. The patients resided in various states, including New Jersey, in which Ellis is not licensed to practice medicine.

He was arrested July 10 in New Jersey on a bond of $250,000, according to records from the U.S. District Court for the District of New Jersey. He was released later the same day.

Following his release, Ellis was restricted from any travel outside New Jersey, Florida or Massachusetts, court records said.

Ellis has been licensed to practice medicine in Florida since 2006, according to Florida Department of Health records. He has no prior disciplinary cases or complaints.

Ellis also was a member of the Alachua County Medical Society in 2018 but did not renew his membership in 2019, said Executive Vice President Jackie Owens.

Physicians and retired physicians who are members of the Alachua County Medical Society run a free clinic for underserved populations in the county by volunteering their time, Owens said.

She had not heard about Ellis' charge and said the group has no comment on the allegations. Ellis also was licensed to practice medicine in Pennsylvania until his license expired Dec. 31, 2012, Pennsylvania Department of State records said.

He had no disciplinary actions in Pennsylvania, the records said.

Ellis has had a courtesy appointment at the University of Florida’s College of Medicine as a clinical assistant professor since 2010, said UF spokesman Steve Orlando. He specializes in family medicine, Orlando said.

Three other Florida physicians, Dr. Edward B. Kostishion, 59, of Lakeland; Dr. Kacey C. Plaisance, 38, of Altamonte Springs; and Dr. Jeffrey Tamulski, 46, of Tampa, also are charged in the investigation.

Dr. Kyle D. Mclean, 36, of Arlington Heights, Illinois, and Dr. Jeremy Richey, 39, of Mars, Pennsylvania, also are being charged in New Jersey.